Abstract：
:The relative analgesic efficacy and side-effect profile of peripheral nerve blockade (PNB) techniques compared with lumbar epidural analgesia for major knee surgery is unclear. We undertook a systematic review and meta-analysis of all randomized trials comparing epidural analgesia with PNB for major knee surgery. Eight studies were identified that had enrolled a total of 510 patients of whom 464 (91%) had undergone total knee joint replacement. All were small trials and none was blinded (Jadad score 1-3). PNB technique was variable: in addition to a femoral catheter (n=5), femoral single shot (n=2), or lumbar plexus catheter (n=1) techniques, sciatic blockade was performed in three trials. There was no significant difference in pain scores between epidural and PNB at 0-12 or 12-24 h, WMD 0.22 (95% CI: -0.36, 0.81), 0.05 (-1.01, 0.91), respectively, and no clinically significant difference at 24-48 h, WMD -0.35 (-0.64, -0.02). There was also no difference in morphine consumption (mg) at 0-24 h, WMD -6.25 (-18.35, 5.86). Hypotension occurred more frequently among patients who received epidurals [OR 0.19 (0.08, 0.45)], but there was no difference in the incidence of nausea and vomiting. Two studies reported a higher incidence of urinary retention in the epidural group. Patient satisfaction was higher with PNB in two of three studies which measured this, although rehabilitation indices were similar. PNB with a femoral nerve block provides postoperative analgesia which is comparable with that obtained with an epidural technique but with an improved side-effect profile and is less likely to cause a severe neuraxial complication.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Fowler SJ,Symons J,Sabato S,Myles PSdoi
10.1093/bja/aem373subject
Has Abstractpub_date
2008-02-01 00:00:00pages
154-64issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)34556-7journal_volume
100pub_type
杂志文章,meta分析,评审abstract：BACKGROUND:Double-lumen tubes (DLTs) are frequently used to establish one-lung ventilation (OLV). Their correct placement is crucial. We hypothesized that electrical impedance tomography (EIT) reliably displays distribution of ventilation between left and right lung and may thus be used to verify correct DLT placement ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aen166
更新日期：2008-09-01 00:00:00
abstract：:We conducted a randomized, double-blind comparison of 8% sevoflurane and propofol as induction agents for day-case cystoscopy in 102 patients. All patients received an i.v. cannula and breathed oxygen 5 litre min-1. Anaesthesia was induced with propofol i.v. or inhalation of 8% sevoflurane and 10% Intralipid (as a pla...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/78.4.356
更新日期：1997-04-01 00:00:00
abstract：:We present an unusual case of hypercapnia and surgical emphysema during transanal endoscopic microsurgery, which led to delayed post-operative ventilatory failure. The hypercapnia and surgical emphysema were secondary to rectal insufflation with carbon dioxide used to facilitate visualization and resection of a rectal...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/86.4.586
更新日期：2001-04-01 00:00:00
abstract：:A 55-yr-old man received a left supraclavicular brachial plexus block with 0.42% bupivacaine; he had profound motor and sensory block 26 h after injection; complete recovery occurred at 40 h. ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/63.5.604
更新日期：1989-11-01 00:00:00
abstract：:We have assessed tracheal intubating conditions in 60 ASA I or II patients after induction of anaesthesia with propofol 2.5 mg kg-1 and alfentanil 10 or 20 micrograms kg-1 with or without i.v. lignocaine 1 mg kg-1. No neuromuscular blocking agents were administered. Patients were allocated randomly to four groups: gro...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/70.2.163
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:The perioperative management of two-stage oesophagectomy has not been standardized and the prevailing practice regarding the timing of extubation after the procedure varies. This audit has evaluated the outcome, in particular the respiratory morbidity and mortality, after immediate extubation in patients who...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeg091
更新日期：2003-04-01 00:00:00
abstract：:A 38-yr-old woman with an atrial septum defect and Eisenmenger syndrome was scheduled for a lung biopsy via thoracoscopy during one-lung ventilation. Fluids were given to increase central venous pressure to 8 mm Hg, an epidural catheter was inserted at the sixth thoracic intervertebral space and ropivacaine 0.3%, 6 ml...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeh104
更新日期：2004-04-01 00:00:00
abstract：:We have evaluated the level of state and trait anxiety, neuroticism, extroversion and coping style as predictors of the effectiveness of patient-controlled analgesia (PCA) in 110 patients undergoing total abdominal hysterectomy. After operation patients were allocated to receive pain control with either PCA or i.m. in...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/74.3.271
更新日期：1995-03-01 00:00:00
abstract：:We have undertaken a prospective, randomized study to determine the incidence of postoperative nausea and vomiting during intensive care stay after cardiac surgery, and to study the effect of addition of droperidol to an infusion of morphine used for postoperative analgesia. Data from 398 patients were examined. The u...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/77.3.356
更新日期：1996-09-01 00:00:00
abstract：:We investigated whether low-dose erythromycin (200 mg) given as an oral premedicant altered the residual gastric volume and its acidity in fasted patients at induction of anaesthesia in a single-blinded study. Sixty patients were allocated randomly to receive either an erythromycin tablet (200 mg) or nothing with 10 m...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/85.6.861
更新日期：2000-12-01 00:00:00
abstract：BACKGROUND:The purpose of this observational study was to investigate the relationship between splanchnic and renal blood flow during infrarenal aortic cross-clamp (XC) and postoperative gastrointestinal perfusion and function. METHODS:Descending aortic blood flow (DABF) was continuously monitored with an oesophageal ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aes095
更新日期：2012-06-01 00:00:00
abstract：:Cis AB blood group is a rare variant of the AB blood group resulting from inheritance of both A and B genes on one chromosome. It may lead to misclassification in ABO grouping and clinical misdiagnosis as a result of its divergence from the laws of Landsteiner and Mendel. We encountered a case of cis AB blood group, a...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/83.3.491
更新日期：1999-09-01 00:00:00
abstract：BACKGROUND:Brachytherapy presents the anaesthetist with unique problems. Information on anaesthesia for brachytherapy, however, is limited. The aim of this paper is to report on our experience involving a large number of brachytherapy procedures. METHODS:A retrospective analysis of records of 1622 anaesthetic procedur...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aei301
更新日期：2006-02-01 00:00:00
abstract：:Haemodynamic effects may occur after stellate ganglion block (SGB) arising from autonomic imbalance and local anaesthetic infiltration to barosensitive areas. We report seven patients who developed severe hypertension (systolic arterial pressure >200 mm Hg) after SGB in our pain clinic service. We postulate that diffu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aei134
更新日期：2005-06-01 00:00:00
abstract：:Integrated electromyographic studies in burned patients, and in normal controls, during the administration of small doses of suxamethonium (0.1 or 0.2 mg kg-1) have shown that the level of paralysis and the duration of paralysis are significantly increased in burn patients and that the effect is greater with larger bu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/59.8.1017
更新日期：1987-08-01 00:00:00
abstract：:There is compelling evidence that preconditioning occurs in humans. Experimental studies with potential clinical implications as well as clinical studies evaluating ischaemic, pharmacological and anaesthetic cardiac preconditioning in the perioperative setting are reviewed. These studies reveal promising results. Howe...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aeg206
更新日期：2003-10-01 00:00:00
abstract：:Postoperative management following major surgery in patients with neuromuscular disorders associated with scoliosis is frequently complicated by sputum retention and ventilatory failure. This report demonstrates the successful perioperative management of an 11-yr-old boy with type II spinal muscular atrophy undergoing...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aef227
更新日期：2002-10-01 00:00:00
abstract：:We have examined the correlation between the evoked electromyographic response in the first dorsal interosseous muscle of the hand, temperature and forearm position in 40 female patients after enflurane anaesthesia with spontaneous breathing. In 20 patients the supinated forearm with the wrist extended was immobilized...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/72.4.407
更新日期：1994-04-01 00:00:00
abstract：:Pyridostigmine 0.143 mg kg-1 (maximum 10 mg) and atropine 0.0143 mg kg-1 (maximum 1 mg) were administered i.v. to six healthy male volunteers. Peripheral venous blood samples were drawn for measurement of serum cholinesterase activity. Maximum inhibition of the enzyme was found 5 min after injection with a decrease to...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/57.2.204
更新日期：1985-02-01 00:00:00
abstract：:Fresh gas flows of nitrous oxide, oxygen and halothane at 6, 3, 2 and 1 litre/min were introduced into a circle absorber system. Spontaneous respiration and IPPV were studied and a regression of inspired on delivered oxygen concentration % was calculated. The difference between delivered and inspired oxygen concentrat...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/48.3.217
更新日期：1976-03-01 00:00:00
abstract：BACKGROUND:Acute pulmonary embolism (APE) is an important clinical problem in patients after major surgery and often remains a difficult diagnosis because of unspecific clinical symptoms. Therefore, we investigated the role of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) for the detection of APE. MET...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aes315
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:The low and moderate doses of dexmedetomidine reduce arterial pressure and heart rate (HR), suggesting attenuation of sympathetic activity and dominance of cardiac-vagal activity. These autonomic responses under dexmedetomidine sedation may attenuate cardiovascular reflex responses to temporal reduction in a...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/aep210
更新日期：2009-10-01 00:00:00
abstract：:Procaine has been advocated in the treatment of malignant hyperpyrexia, whereas lignocaine has been shown to worsen the condition. Using muscle from patients susceptible to malignant hyperpyrexia in vitro, it has been demonstrated that muscle contracture can occur with procaine on its own, and in one patient the halot...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/47.1.17
更新日期：1975-01-01 00:00:00
abstract：:We report a case of lumbar extradural abscess that presented 9 days after an elective Caesarean section performed under combined spinal-extradural anaesthesia. This was successfully treated conservatively with full recovery. The clinical course included development, and then resolution, of mild paraparesis. Conservati...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/78.5.591
更新日期：1997-05-01 00:00:00
abstract：:The speeds of onset of pancuronium, atracurium and vecuronium are increased by prior administration of magnesium sulphate. A prospective, randomized, double-blind, controlled, clinical study was performed to examine the effects of prior i.v. administration of magnesium sulphate 60 mg kg-1 on the neuromuscular blocking...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/79.1.122
更新日期：1997-07-01 00:00:00
abstract：:Buprenorphine 0.3 mg or fentanyl 0.125 mg i.v. were used to supplement nitrous oxide anaesthesia in a double-blind investigation of 40 patients undergoing major abdominal surgery. Initially both narcotics appeared to suppress tachycardia and increased arterial pressure in response to surgery, but 80% of the patients w...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/52.4.453
更新日期：1980-04-01 00:00:00
abstract：:Chronic pain affects ∼20% of the European population and is commoner in women, older people, and with relative deprivation. Its management in the community remains generally unsatisfactory, partly because of lack of evidence for effective interventions. Epidemiological study of chronic pain, through an understanding o...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aet123
更新日期：2013-07-01 00:00:00
abstract：BACKGROUND:Evidence-based international expert consensus regarding anaesthetic practice in hip/knee arthroplasty surgery is needed for improved healthcare outcomes. METHODS:The International Consensus on Anaesthesia-Related Outcomes after Surgery group (ICAROS) systematic review, including randomised controlled and ob...
journal_title：British journal of anaesthesia
pub_type： 共识发展会议,杂志文章,meta分析
doi：10.1016/j.bja.2019.05.042
更新日期：2019-09-01 00:00:00
abstract：INTRODUCTION:In the context of an increasing number of publications of trial data analysed by Bayesian methods, clinicians need support to better understand Bayesian statistical methods. The existing checklists are intended for people who already know these methods. We aimed to establish and validate a checklist that c...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2020.04.093
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:The incidence of pain on injection of propofol remains unacceptably high in children, despite various strategies to reduce it. A new drug formulation of propofol has, in adult studies, been reported to cause less injection pain compared with other propofol solutions. The aim of the present prospective random...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/aei156
更新日期：2005-08-01 00:00:00
